Welcome to the National Association of County and City Health - PowerPoint PPT Presentation

Welcome to the National Association of County and City Health Officials’ Webinar on PrEP and Local Health Departments There are two options for accessing the audio portion of this webinar: (1) Using your computer speakers (2) Dialing-in to this conference line – number: 866-740-1260; passcode: 5650851 Please note that to verbally ask a question or make a comment, you MUST dial-in to the conference line. If you are accessing audio via your computer speakers, you will only be able to submit questions and comments via the chat box.

PrEP and Local Health Departments: Module 1 Webinar P R E S E N T E D B Y: M A R K T H R U N , M D A S S O C I AT E P R O F E S S O R , U N I V E R S I T Y O F C O L O R A D O , D I V I S I O N O F I N F E C T I O U S D I S E A S E S D I R E C T O R , H I V / S T D P R E V E N T I O N A N D C O N T R O L , D E N V E R P U B L I C H E A LT H D I R E C T O R , D E N V E R P R E V E N T I O N T R A I N I N G C E N T E R

Module 1 Overview Webcast 1: PrEP for HIV Prevention: An Introduction Webcast 2: Beyond the Basics: The Science of PrEP Webcast 3: US Public Health Service Clinical Practice Guidelines for PrEP

PrEP: What are we talking about? • A new HIV prevention option that utilizes antiretroviral HIV medications to prevent HIV infection before exposure to HIV • Involves taking daily oral tenofovir disoproxil fumarate plus emtricitabine (TDF/FTC) o Combination pill (brand name Truvada) o Approved by the U.S. Food and Drug Administration for use as HIV treatment in 2004 o Approved for use as PrEP in July 2012

Treatment Action Group: A Double-Helix HIV Prevention and Care Continuum http://www.treatmentactiongroup.org/tagline/2014/spring/forgotten-negatives-limits-treatment-prevention

The Science Behind PrEP Evolution of HIV therapies related to HIV prevention: • Highly active antiretroviral therapy (HAART) • Prevention of mother-to-child transmission (PMTCT) • Post-exposure prophylaxis (PEP) • Treatment as prevention (TasP) • Pre-exposure prophylaxis (PrEP)

The Science of PrEP PrEP clinical trials show efficacy of 44-73%, with greater levels of efficacy (reaching 92%) among patients who took the pill consistently. • iPrEx Study: PrEP in MSM • TDF2: Heterosexual PrEP Study • Partners PrEP Study: Heterosexual Serodiscordant Couples • Bangkok Tenofovir Study: PrEP in Injection Drug Users

Increased Adherence Associated with Increased Efficacy Efficacy 84% 100% Grant, Lancet, 2014

Prevention Science Overview: Biomedical Intervention Efficacy 100 90 80 70 60 50 40 30 20 10 0 Modified from Abdool Karim, Lancet, 2011

Key Messages of the Guidelines

http://www.cdc.gov/hiv/pdf/PrEP_fact_sheet_final.pdf

Clinical Provider’s Supplement

What can local health departments do? • Develop community profiles for HIV prevention planning • Create resource inventories Local Health • Educate at-risk community members, Departments healthcare providers, and other HIV prevention and PrEP partners • Conduct risk assessments and make referrals for PrEP • Support PrEP delivery (e.g. HIV and STI screening, adherence and behavioral risk counseling support) • Deliver PrEP via health department clinics • Evaluate and monitor HIV incidence and key PrEP performance measures

Public Health and PrEP Provider Local public health (PH) Epidemiologic PH serves an ideal role as a and At-risk person effectiveness research connector between many parts of a broader network. Prevention and screening programs

Question, Answer, and Discussion

Instructions for Asking a Question or Making a Comment • Submit your question or comment via the chat box. • If you are dialed-in via the conference line and would like to ask a question or make a comment verbally: o Raise your hand by clicking this button at the top of your screen. o We will call on you to speak and instruct you to enter *7 to un- mute your line. o After you are done speaking, mute your line by pressing the mute button on your phone or entering *6 and click on the raise hand button to lower your hand.

NACCHO’s Educational Series on PrEP and Local Health Departments Module 1 PrEP for HIV Prevention: An Introduction Beyond the Basics: The Science of PrEP US Public Health Service Clinical Practice Guidelines for PrEP Module 2 Who Might Benefit from PrEP: Population-level Risk Assessments Who Might Benefit from PrEP: Individual-level Risk Assessments Module 3 Increasing PrEP Awareness and Knowledge in Your Jurisdiction Incorporating PrEP into Comprehensive HIV Prevention Programs NACCHO’s educational series about PrEP was supported by funding from Gilead Sciences, Inc.

NACCHO’s Educational Series on PrEP and Local Health Departments Module 2 Webcast release: Monday, November 3 Live webinar: Friday, November 21 from 1:00-2:00 PM EDT Module 3 Webcast release: Monday, December 1 Live webinar: Tuesday, December 16 from 1:00-2:00 PM EDT NACCHO’s educational series about PrEP was supported by funding from Gilead Sciences, Inc.